Dr Evan Harris (Oxford West & Abingdon, Liberal Democrat)

I have two points to add. I note the spirit in which the amendment has been tabled, which gives us the opportunity to raise points on the issue.

My first point relates to gender change tourism. It seems to me that the word ''tourism'' is far too often added pejoratively at the end of a phrase in the media—I am not accusing the hon. Member for Daventry of that—to describe things that are anything but tourism. While recognising that such activities may be only a remote possibility, we ought to take note that people go abroad for treatment either because it is not available in this country, or because a particular specialism or specialist is available in another country. In the changing world of EU service provision, the NHS may increasingly commission such treatment in countries where there is experience that does not exist in this country. Given the expertise and critical mass required, it may have to do so, at least in the short term. People may seek recognition in states where there is not adequate supervision, but that is different from going abroad for entirely legitimate surgery.

My second point relates to the recognition of marriages of transgendered people whose status has been acquired abroad. That is an issue that we shall discuss under clause 21. I hope to table an amendment that probes the Government on why marriages need to be dissolved, albeit very briefly, in order for a gender recognition certificate to be issued.

In relation to amendment No. 2, I note the question of the ''approved country or territory'' in clause 2(4). Perhaps the Minister will find it convenient to clarify

on what basis an approved country or territory is to be prescribed by order. Will there be a process for that? I am sure that it will not be arbitrary, but some detail should be provided to ensure that that is not the case. There may be implications for how we tackle the issue of marriage when we get to clause 21.

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